Insurance Denials Specialist III

RAYUS Radiology; Saint Louis Park (MN); Remote; USD 30,000 - 44,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401k with company match

Life and disability insurance

Tuition reimbursement

Adoption assistance

Pet insurance

PTO and holiday pay

Job summary

RAYUS Radiology is seeking an Insurance Denials Specialist III for a 100% remote role. Responsibilities include researching denied claims, following up with payers, and expediting collections. The position requires prior medical billing experience and strong Excel proficiency.

The role offers a 40-hour work week with corporate hours and a pay range of $22.40–$31.87 per hour, with benefits and DailyPay options. Remote work is supported from Minnesota.

Qualifications

• Experience in medical billing or payer claim processing.
• Proficient with Microsoft Office and billing systems.
• Knowledge of denial codes and follow-up workflows.

Responsibilities

• Research denied claims and determine reasons for denials.
• Expedite billing and collections of accounts receivable.
• Communicate with patients, payers and colleagues to resolve denials.

Skills

Medical billing

Denials management

Customer service

Team collaboration

Education

High School diploma

Accredited medical billing program

Bachelor's degree (preferred)

Tools

Microsoft Excel

PowerPoint

Word

Outlook

Job description

RAYUS now offers DailyPay! Work today, get paid today!

The pay range for this position is $22.40 - $31.87 based on direct and relevant experience.

RAYUS Radiology is looking for a Insurance Denials Specialist III to join our team. We are challenging the status quo by shining the light on radiology and making it a critical first step in diagnosis and proper treatment. Come join us and shine brighter together! As an Insurance Denials Specialist III you will be responsible for researching denied claims to determine the reason for a denied or unpaid claim and take necessary steps to expedite the medical billing and collections of the accounts receivable. Working in a team environment, you'll communicate with patients, insurance carriers, co-workers, centers, markets, referral sources and attorneys in a timely, effective manner.

This is a 100% remote full-time position working 40 hours per week working corporate hours.

This is a full-time remote position working 40 hours per week. Shifts are from 8:00am-4:30pm.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

(85%) Insurance Denial Follow-up

• Accurately and efficiently reviews denied claim information using the payer's explanation of benefits, website, and by making outbound phone calls to the payer's provider relations department for multiple denial types, payers, and/or states
• Reviews and obtains appropriate information or documentation from claim re-submission for all denied services, per insurance guidelines and requirements
• Communicates with patients, insurance carriers, co-workers, centers, markets, referral sources and attorneys in a timely, effective manner to expedite the billing and collection of accounts receivable
• Documents all communications with coworkers, patients, and payer sources in the billing system
• Contributes to the steady reduction of the days-sales-outstanding (DSO), increases monthly gross collections and increases percentage of collections
• Prioritizes work load, concentrating on "priority" work which will enhance bottom line results and achievement of the most important objectives
• Contributes to a team environment
• Recognizes and communicates trends in workflow to departmental leaders
• Meets or exceeds RCM Quality Assurance standards
• Ensures timely follow-up and completion of all daily tasks and responsibilities

(10%) Staff Support

• Assists in the mentoring and training of new Insurance Denials Specialists
• Recommends and assists in implementing new approaches and ideas for improvement in processes and workflows
• Serves as a resource for Insurance Denials Specialists
• As assigned, acts as department go-to resource for team and others in Lead or Manager's absence

(10%) Performs other duties as assigned

• As backup for customer service team, communicates and responds to customer inquiries as needed

Required:

• High School diploma or equivalent
• 4 years' experience in a medical billing department, prior authorization department or payer claim processing department, or 2+ years' experience as Insurance Denials Specialist within the organization
• Intermediate proficiency with Microsoft Excel, PowerPoint, Word, and Outlook
• Proficient with using computer systems and typing

Preferred:

• Graduate of an accredited medical billing program
• Bachelor's degree strongly preferred
• Knowledge of ICD-10, CPT and HCPCS codes

RAYUS is committed to delivering clinical excellence in communities across the U.S., driven by our passion for and superior service to referring providers and patients. RAYUS Radiology is built on our brilliant medicine, brilliant team, brilliant technology and services - all to provide the highest level of patient care possible.

We bring brilliance to health and wellness. Join our team and shine the light on Radiology Services! RAYUS Radiology is an EO Employer/Vets/Disabled.

We offer benefits (based on eligibility) including medical, dental and vision insurance, 401k with company match, life and disability insurance, tuition reimbursement, adoption assistance, pet insurance, PTO and holiday pay and many more! Visit our career page to see them all www.rayusradiology.com/careers.

• medical insurance
• dental insurance
• vision insurance
• 401k with company match
• life and disability insurance
• tuition reimbursement
• adoption assistance
• pet insurance
• PTO and holiday pay
• many more

DailyPay implementation is contingent upon initial set-up period.